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Choledochal cyst: a changing pattern of presentation.

V Kabra1, M Agarwal, T K Adukai

  • 1Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

ANZ Journal of Surgery
|March 30, 2001
PubMed
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Choledochal cysts present differently now, with older patients and fewer classic symptoms. Hepaticoduodenostomy offers an effective surgical alternative to hepaticojejunostomy for choledochal cyst treatment.

Area of Science:

  • Gastroenterology
  • Surgical Procedures
  • Pediatric Surgery

Background:

  • Choledochal cysts are congenital biliary anomalies.
  • This study investigates the changing presentation patterns and surgical outcomes for choledochal cysts.

Purpose of the Study:

  • To analyze the spectrum of choledochal cyst presentations.
  • To evaluate the efficacy of different surgical interventions for choledochal cysts.

Main Methods:

  • A prospective study of 10 patients with choledochal cysts (1996-2000).
  • Diagnosis confirmed via ultrasonography and endoscopic retrograde cholangiopancreaticography (ERCP).
  • Surgical procedures included cyst excision with hepaticoduodenostomy or Roux-en-Y hepaticojejunostomy, and cystoduodenostomy.

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Main Results:

  • Eight patients underwent cyst excision; four each had hepaticoduodenostomy and hepaticojejunostomy.
  • One patient with hepaticoduodenostomy had a minor, conservatively managed leak.
  • All patients remained asymptomatic at a median follow-up of 36.5 months.

Conclusions:

  • Choledochal cyst presentation is evolving, with a higher mean age and less frequent classical triad.
  • Hepaticoduodenostomy is a viable, effective, and potentially less complex alternative to hepaticojejunostomy for reconstruction.